Neurological Conditions: estimating the prevalence in Scotland of selected conditions using GP and Hospital Admissions datasets

1 Introduction

This report presents the estimated prevalence of (the number or proportion of people in the population with) 28 specific neurological conditions. The primary estimates derive from two separate data sources:

• General Practice (GP) recorded diagnoses: the number of registered patients with a diagnosis ever recorded for the specified condition.
• Hospital Admissions data: the number of people admitted to hospital with a diagnosis for the specified condition recorded in the preceding 20-year period.

This exploratory work was initiated by the Scottish Government and supported by Public Health Scotland (PHS) to address the Data Commitment in the Scottish Government's Neurological Care and Support: Framework for Action 2020-2025, published in December 2019. The Framework noted that neurological conditions account for between 10% and 20% of acute medical admissions, and 10% of the overall burden of disease in Scotland, as measured by Disability-Adjusted Life Years (DALYs). The Framework discussed the challenge in obtaining basic epidemiological data. It highlighted the need for more accurate population-level prevalence estimates to inform service planning and development. It set out the following commitment to address these issues.

Neurological Framework: Commitment 12

We will work with NHS Information Services Division (now part of PHS) and others to ensure a cohesive approach to capturing the needs of people with a neurological condition that will:

• improve the recording of neurological conditions in people's routine health and care records, so that they are visible to appropriate services;
• enable more accurate population-level estimates of the prevalence of neurological conditions to inform other data analysis;
• support the development of systems and processes for service planning and workforce development, based on these improved prevalence estimates.

The purpose of this report is to address that commitment by improving our understanding of the prevalence of selected neurological conditions.

This work builds on a previous briefing paper on the prevalence of neurological conditions prepared by the Scottish Burden of Disease study team for the National Advisory Committee for Neurological Conditions (NACNC). That exploratory analysis covered eight neurological conditions and drew on a range of Scottish and global data sources to show comparisons with findings from other studies. This report adds to that work by:

• Expanding the number of neurological conditions for which estimates are provided.
• Including for the first time general practice recorded diagnoses of specified neurological conditions, provided by the PHS Scottish Primary Care Information Resource (SPIRE) team.
• Including complementary hospital admissions data for most of those specified conditions, provided by the PHS Scottish Burden of Disease (SBoD) study team.
• Including comparisons with other studies, where available and considered robust, for some conditions on the expanded list.

This is new and exploratory work which is intended to start a discussion about how the availability of data about people with neurological conditions could be further improved. Strengths and limitations of the data are presented later in the report.